Chad Thomas Bousamra M.A.

NPI 1164694030 - Counselor - 101YA0400X

NPI Details
NPI 1164694030
Gender Male
Enumeration Date 03/31/2008
Last Updated 03/31/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1105 E EIGHTH ST
TRAVERSE CITY MI, 49686-2936, US
Phone (231) 935-6787
Fax (231) 935-6920
Business Location
1105 E EIGHTH ST
TRAVERSE CITY MI, 49686-2936, US
Phone (231) 935-6787
Fax (231) 935-6920
Toxanomy
Taxonomy Code 101YA0400X
License State Michigan
License Number 6401010758
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According to our database, Chad Thomas Bousamra M.A. NPI is 1164694030, taxonomy code is 101YA0400X and license number is 6401010758, license state is located at Michigan. Chad Thomas Bousamra M.A. physically located at 1105 E Eighth St, Traverse City MI, 49686-2936. NPI Number Chad Thomas Bousamra M.A. has the Individual type.

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1164694030 NPI number is provided on an as is basis without warranty of any kind. 1164694030 is maintained by the National Plan & Provider Enumeration System. The contents of Chad Thomas Bousamra M.A. are for informational purposes only.